Cerebral Palsy: Types, Signs, Symptoms, and Causes
Cerebral palsy (CP) is a term used to describe a group of brain-related disorders that affect movement, muscle tone, posture, and motor skills. Cerebral palsy is caused by a malformation of the brain or a brain injury before, during, or after birth. There is no cure for CP. However, through physical and occupational therapy, speech therapy, medications, and assistive devices, a child’s capabilities may be significantly improved.
Cerebral palsy is the most prevalent motor disability in children. According to the Center for Disease Control (CDC), about one in 323 children are diagnosed with CP.
More than half of children with a CP diagnosis are likely to suffer from at least one other co-occurring condition.
- Epilepsy – Between 35 and 41 percent of children diagnosed with CP also have epilepsy, which is characterized by unpredictable seizures.
- Intellectual disability – Approximately 40 percent of children with CP suffer an intellectual disability, limiting their reasoning, learning, and problem-solving abilities.
- Autism spectrum disorder (ASD) – While ASD affects just one percent of children in the United States, seven percent of children diagnosed with CP are also diagnosed with ASD.
- Multiple co-occurring conditions – In about 25 percent of cases, children with CP have both epilepsy and an intellectual disability.
Motor disorders like CP often affect a child’s ability to walk.
- 58.2 percent of children with CP can walk independently
- 11.3 percent can walk with the assistance of a hand-held mobility device, such as a cane
- 30.6 percent have limited or no ability to walkAs with other severe birth injuries, the nature and extent of CP symptoms vary depending on the type and severity of the disorder
Types of Cerebral Palsy
Doctors classify CP according to the movement disorder or disorders exhibited by a patient. Three types of movement disorders can be the basis of a CP diagnosis, each of which results from damage to a particular part of the brain.
Ataxia – Ataxia is a balance and coordination impairment caused by damage to the cerebellum. The cerebellum is the part of the brain responsible for fine motor skills and balance. Ataxia can affect any part of the body, and those with ataxic cerebral palsy may exhibit unsteady or shaky movement, a difficult time balancing, and poor depth perception. Ataxic cerebral palsy is the least common form of CP.
Spasticity – The most common type of CP, spastic cerebral palsy, is caused by damage to the motor cortex of the brain. Spasticity is a form of hypertonia, or increased muscle tone. Those who suffer from spastic CP may have difficulty moving from one position to another and controlling individual muscle groups necessary for performing certain tasks, such as grasping objects or speaking.
Dyskinesia – Dyskinesia isa movement disorder characterized by involuntary movements. Dyskinetic CP results from damage to the basal ganglia, which is a group of structures in the brain that assist with movement. Depending on which of the structures are affected, someone may experience these symptoms:
- Dystonia – Dystonia causes involuntary and repetitive twisting motions that may be localized or impact the entire body. Involuntary movements can be painful and occur more frequently when someone is tired, anxious, tense, emotional, or experiencing pain.
- Athetosis – Characterized by slow, writhing, involuntary motions, often affecting the face, neck, hands, or feet, athetosis affects the ability to maintain a posture. Athetosis may cause the appearance of restlessness.
- Chorea – Stemming from the Greek word for dance, chorea refers to brief, abrupt, and involuntary movements. Those who suffer from severe chorea exhibit wild, violent movements.
The Signs of Cerebral Palsy
While the signs of CP may appear in the first few months of life, children often are not diagnosed until after the age of two. In young children, symptoms of CP include:
- Abnormal muscle tone
- Abnormal posture
- Developmental delays
It may be difficult for parents to assess an infant’s muscle tone and posture. Thus, many parents first notice that their child may have CP when their child is consistently missing physical milestones.
- By six months, infants should be able to hold up their heads on their own when picked up. Early signs of CP include when an infant cannot hold up their head, their body feels stiff or floppy, or the child’s legs cross when picked up.
- Between six months and one year, infants should be able to roll over and have independent movement of their limbs. If a child cannot roll or cannot bring their hands together, it may indicate that the child suffers from CP.
- At ten months of age, children should be able to crawl and begin to stand. If a child drags one hand or leg while crawling or cannot stand even while supported, it may be a sign of CP.
Cognitive milestones are also crucial in determining whether a child may have CP. However, not all children with CP suffer from cognitive impairments. The most recognized cognitive milestones are:
- Two months: Infants begin to recognize faces and start to track loved one’s faces.
- Four months: Babies start to enjoy playing with toys, respond to parental affection, and exhibit emotions of their own.
- Six months: Babies begin to more intently observe their immediate surroundings and exhibit curiosity at things beyond their reach.
- Twelve months: Children begin to point at objects, will mimic loved one’s faces and can follow simple instructions.
- Eighteen months: Children should be able to recognize everyday objects and follow more complex directions.While it is not uncommon for a child to miss one or two milestones, when a child frequently misses milestones, parents should have their child tested for CP.
Diagnosis and Care of Young Children with Cerebral Palsy
Parents of children who exhibit the symptoms of CP should discuss their concerns with their pediatrician. Most children are diagnosed with CP by age two; however, if a child suffers from mild symptoms, a diagnosis may be delayed. Doctors rely on developmental monitoring and screening to diagnosis CP.
Once a child obtains a CP diagnosis, they may be referred to a specialist. Choosing the right specialist is a crucial part of a child’s treatment plan because many children with CP also have related developmental conditions such as intellectual disability, seizures, or problems with vision, hearing, or speech. Depending on the young patient’s specific needs, this may include a referral to a neurodevelopmental pediatrician, child neurologist, or pediatric physiatrist.
Children with CP often require additional help in school. Early intervention programs are available to children with CP through their third birthday. Once a child reaches preschool, special education programs help by providing additional attention to students who need assistance. By law, schools must work with parents and children to create individualized education plans when necessary. Schools may also offer assistive technology such as communication devices or computer technology at no cost to parents.
What Causes Cerebral Palsy?
Cerebral palsy is caused when a developing brain is damaged during pregnancy or birth or by abnormal brain development. Brain damage can occur at any time throughout pregnancy, during birth, or after a baby is born. The most common causes of brain damage during the birthing process include deprivation of oxygen or, if a complicated or lengthy labor occurs, physical trauma.
Cerebral palsy can be congenital or acquired. Congenital CP results from damage to the brain during pregnancy or birth. According to the CDC, between 85 and 90 percent of CP cases are congenital. Doctors use risk factors to assess the likelihood that a child will develop congenital CP.
Risk factors for CP include:
- Birth complications
- Premature birth
- Low birthweight
- Multiple births
- Use of fertility treatment before pregnancy
- Infections during pregnancy
It is the job of the obstetrician or mid-wife to identify risk factors and manage obstetric care during pregnancy and delivery according to recognized standards of practice. The failure to provide standard obstetric care can be the legal cause of catastrophic injuries such as CP.
A small percentage of CP is caused by brain damage occurring more than 28 days after birth. Doctors’ call this acquired CP. Acquired CP is most often the result of an infection such as meningitis or encephalitis but can also result from the inappropriate medical management of a baby during its early life. Mismanagement of issues such as infection or high bilirubin can result in a child developing CP and related complications.
Contact an Experienced Michigan Birth Injury Attorney
If your child is diagnosed with CP, choosing a law firm to pursue a birth injury lawsuit can be the most important decision you make for your child’s and your family’s future.
At the Michigan birth injury law firm of Sommers Schwartz, we help families of children born with preventable forms of CP. We pursue claims for financial compensation against the parties responsible for their child’s injuries.
Our attorneys have been trailblazers in the arena of birth injury lawsuits. A two-volume text devoted to handling birth injury lawsuits effectively and successfully was authored by two of our alumni. Sommers Schwartz attorneys have routinely been invited to speak at birth injury conferences.
Our successful track record for winning birth injury lawsuits is impressive .We are the firm lawyers and doctors recommend to their friends and family.
To learn more about how we can help your family pursue a Michigan medical malpractice case, call us at 1-800-783-0989 to schedule a free consultation. Because we work on a contingency basis, we will not bill you for any of our efforts in handling your case unless we obtain the compensation your family deserves. Call today or contact us online.